Osteoarthritis guidelines released Wednesday advocate for patient self-management programs, with many featuring exercise.
The guideline, updated from 2012 by the American College of Rheumatology and the Arthritis Foundation, includes changes that recognize the disease’s many clinical presentations and numerous treatment options. “Clinicians and patients can choose from educational, behavioral, psycho-social, mind-body, physical and pharmacological approaches,” said lead author Sharon Kolasinski, M.D.
Strongly recommended interventions include:
- Tai chi for the knee and hip
- Topical NSAIDs for knee and hand osteoarthritis
- Oral NSAIDs and intra-articular steroids for the knee and hip
New conditional recommendations include:
- Balance exercises for the knee and hip
- Duloxetine for the knee
- Yoga, cognitive behavioral therapy, radiofrequency ablation and kinesiotaping for the first carpometacarpal and knee
The guidelines also advise against using intra-articular hyaluronic acid injections for the first carpometacarpal and knee. Hyaluronic acid injections should also be avoided for patients with hip osteoarthritis, they noted.
“A number of agents have been tested and fail to show adequate benefit to justify their use, while others will require additional investigations to clarify their place in the osteoarthritis armamentarium,” said Kolasinski.
The 2019 ACR/AF Guideline for the Management of Osteoarthritis of the Hand, Hip and Knee is available on the American College of Rheumatology’s website.
